Tuesday, 13 November 2012

Me and SPD

This is me taken just 2 weeks before my first baby arrived.
See the great big smile? I was so excited. See the crutches and the big support 'corset'? No? You're right, I left them on the grass, hidden out of view. A deliberate decision, I didn't want to look back in the years to come and remember the agony I was in.

It started when I was 10weeks pregnant, over Christmas. I tried to help my father-in-law plug in his new digital satellite receiver to the TV and came back from squatting on the floor in quite a bit of discomfort. Not in my back so much but more like a Dane axe had hit me between the legs. In the coming weeks I remember sitting on the side of my bed in the mornings crying because of the pain I was in. I spoke to my midwife and my GP about it and was basically told to toughen up. Only when I spoke to my consultant  and he saw how upset I was that I got a referral to the physio. (I got to see my cons regularly as a 'higher risk' pregnancy, I think he just wanted to keep an eye on me because he is the same guy who had seen us for over 5 years of IVF treatment.)

The physio was a friendly lady who diagnosed SPD or Symphysis Pubis Dysfunction.  Basically the interpubic ligament had stretched (as it is supposed to do in pregnancy to allow the hips to widen) but possibly too much. The way it was explained to me was that while you are pregnant your body releases a hormone called relaxin. The job of relaxin is not to chill out on the sofa while watching day-time TV (relaxing - get it?), no it's job is to loosen the ligaments between the two sides of your pelvis allowing it to open up and ultimately allow baby through that tiny gap known as the birth-canal. I was told that either my body was making too much relaxin or my body was over sensitive to it, ligaments were over stretching and that was what was causing the pain and this was apparently supported by the way my ankles and knees were giving way by then.

To have a 'diagnosis' was nice, for starters it got me permission to park in the disabled bay at work (don't judge me badly, I really couldn't walk 50m unaided). To have a set of exercises (including Kegals) to do gave me something to focus on, to at least feel like I was controlling it in some tiny way helped. The SPD continued right through my pregnancy and much to my shock, beyond. Though things did improve 6 months later I still taking painkillers for it and was concerned enough to get referral from my GP to another physio-terrorist. (She wasn't as nice as the first one, hence the nickname I gave her). I got even more Kegals and even more 'core' body exercises. Frankly my pelvic floor was developing all the tightness of a steel bear-trap and when it came to the next round of fertility treatment for a sibling for our precious baby things were decidedly uncomfortable. (I'll spare you the details of what they have to do, save to say that it is significantly worse than having a pap smear.)

We were delighted when we found I was pregnant for a second time and waited anxiously to see if the SPD returned. It took less than 10 weeks. Once again I got a physio referral and this time I got a diagnosis of Pelvic Girdle Pain, don't be confused these are more or less the same thing, just this time the pain wasn't quite so bad. I had some extra exercises and as recommendations on analgesics in pregnancy  had changed I got some better pain relief.  I was told it was probably better this time because the baby was going to be smaller - WRONG. Baby number 2 was a staggering 40% bigger than the first, though I survived the birth somewhat better.

When the pain persisted after birth I was told that it was because I was breastfeeding. (WHAT??!! I need relaxin to breastfeed?!! NO way.)
Thinking about it that should have been my first clue that the people I was talking to didn't know what was going on. Anyway I ignored them, tried hard to ignore the pain, put my head down, kept calm and carried on breastfeeding. 

Roll forwards a couple of years and I was still doing the exercises a couple of times a day, yet the pain had not improved. To make matters worse in trying to improve my fitness and lose some baby weight I'd gone to a few exercise classes and given myself groin strain. I resigned myself to always having a weak back and pelvis for the rest of my life, after all plenty of the women in my family had similar pains.

Just over 6 months ago then I was searching on the internet for 'Pelvic pain' and it was then that I found Katy Bowman's blog and just like my life is divided between the time before I had children and after they arrived I think it's also divided between 'life before I found Katy' and 'after Katy'.

I think Katy has a reputation as something of a maverick particularly on pregnancy and baby websites and forums. She suggests that you forget about the Kegels (YES!!) and start thinking about how the bones in your body are stacked up (by our muscles and ligaments), it's mis-alignment in this she says that is causing our problems. Reading her work, it sounded like everything from pelvic floor dysfunction (that's more or less the modern way of saying 'I can't really control my wee') to foot pain, even prolapse and oesteoporosis could be sorted by better alignment of our bones and ligaments. What did I have to loose? I'd already been doing Kegels for 6 years and not only were they not working, I was more than ready to never do another one. Added to that no prolapse and the fact that my mum has severe oesteoporosis which I'd happily avoid  - YES PLEASE!

So I bought a few of her DVD's and set to work. Six months later, the pelvic/hip pain has nearly gone, back pain I didn't know was there has gone, my feet have grown a shoe size, I can sneeze and cough without visiting the toilet first (is that TMI?) and I can nearly run (which let's face it is about as good as ever I was before pregnancy). It's fab and as an added bonus although my weight has only dropped just over half a stone my clothes size has dropped from 14/16 down to a 10!!

I now feel like I'm on a mission, I have to tell everyone how important it is to get your body in alignment, especially if that person is likely to get pregnant anytime soon. And if I had one tip? Swap the heels for some powerflats, get a half-dome and get stretching. 

I felt completely vindicated this week when Katy, started writing on her blog and facebook page about relaxin and what it can do to your body.

PREGNANCY SCIENCE UPDATE: The hormone RELAXIN inhibits uterine contraction, increases the length of the interpubic ligament, and softens the cervix. IT DOES NOT increase the laxity of the joints nor affect the whole body, making pregnant women more susceptible to joint injury.
What we do have is a widespread issue of women without enough strength to carry the rapidly-increasing load of pregnancy, then straining their ligaments, and getting injured. 

Basically I came to realise what I should have figured from the start, my body wasn't strong enough pre-pregnancy (at least not in the right places) and I simply wasn't aligned so when my Symphysis Pubis started to lengthen it came under extra force and torsion from a 'mis-aligned' body and the added baby weight and that's what caused a lot of the pain. So the truth was I was in rotten pain but I suspect that the other truth is that in my case this was almost entirely preventable. In fact my second pregnancy goes someway to supporting this, my second pregnancy wasn't as painful because some of the exercises I was doing had helped me become more aligned. (Not the ones the physio-terrorist gave me though, working with some similar sufferers on line we'd done our research and found exercises that seemed to have a higher success rate.)

The numbers of pregnant women in the western world who are suffering from SPD is increasing and it's not just because doctors and midwives are getting better at spotting it. More and more you will see pregnant ladies sporting a great belt and a pair of crutches. And why? It's because we don't move enough!! We sit or slump on chairs in front of our computers or TV and mistake it for working our bodies. Ladies, to quote Katy  "you don't know squat!" Get up, get moving and get aligned.

I'm off for a walk into the village and back! xxx


  1. Hey there! Saw your link from Aligned and Well FB page and, AMEN sister! It is kind of crazy how we feel about Katy, eh? But her work has been that life changing for me as well. And Physio-terrorist? LOL on that one, I totally know what you mean... I was a victim of the relaxin theory, too. Anyway, loved your post. Thanks for writing and sharing!